HPV vaccination program premature, experts warn

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Questions and concerns must first be addressed, cautions McGill professor

The federal government's plan to introduce a Canada-wide vaccination program for women and girls against the human papillomavirus is premature and could have unintended negative consequences, a review led by McGill University Professor Abby Lippman.

"There are a number of unanswered questions that need to be addressed before setting up a vaccination program," said Prof. Lippman, a professor in McGill's Department of Epidemiology, Biostatistics and Occupational Health, a member of the Canadian Women's Health Network (CWHN) and lead author of Human papillomavirus, vaccines and women's health: questions and cautions, a commentary to be published in the August 28 edition of the Canadian Medical Association Journal.

Prof. Lippman, along with colleagues at the CWHN, the Department of Bioethics at Dalhousie University and the Women's Health Clinic in Winnipeg, reviewed a variety of literature, including manufacturer's literature submitted with the application for approval of Gardasil, the currently used HPV vaccine. Some of the unanswered questions they cite include: "Where are the data on the effectiveness of the HPV vaccine when co-administered with other immunizations, as may occur in real practice? How will factors such as a person's nutrition status, smoking status and general health influence the safety or usefulness of the HPV vaccine?"

Although the vaccine may prevent primary infection with HPV types 16 and 18, thought to cause about 70 percent of cervical cancer, a lack of sufficient data on the vaccine's effectiveness and clear, tangible goals of the proposed nationwide vaccination program is cause for concern, they say.

Prof. Lippman and her colleagues urge the government to educate the public about the realities of cervical cancer, HPV infection and HPV vaccinations, to set clear goals for a mass vaccination program and to support unbiased research to collect data that is now missing.

"Let's take the time to come up with solid policy decisions based on real evidence," said Prof. Lippman.